| National Provider Identifier [NPI]: | 1568448710 |
| Last Name Of The Provider | SUSSMAN |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 213 |
| Number Of Services | 10836 |
| Number Of Medicare Beneficiaries | 2470 |
| Total Submitted Charge Amount | 1348253.45 |
| Total Medicare Allowed Amount | 325171.26 |
| Total Medicare Payment Amount | 246792.78 |
| Total Medicare Standardized Payment Amount | 229953.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7524 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 22656 |
| Total Drug Medicare AllowedAmount | 2110.23 |
| Total Drug Medicare PaymentAmount | 1654.34 |
| Total Drug Medicare Standardized Payment Amount | 1654.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 210 |
| Number Of Medical Services | 3312 |
| Number Of Medicare Beneficiaries With Medical Services | 2468 |
| Total Medical Submitted Charge Amount | 1325597.45 |
| Total Medical Medicare Allowed Amount | 323061.03 |
| Total Medical Medicare Payment Amount | 245138.44 |
| Total Medical Medicare Standardized Payment Amount | 228299.37 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 307 |
| Number Of Beneficiaries Age 65 to 74 | 871 |
| Number Of Beneficiaries Age 75 to 84 | 809 |
| Number Of Beneficiaries Age Greater 84 | 483 |
| Number Of Female Beneficiaries | 1341 |
| Number Of Male Beneficiaries | 1129 |
| Number Of Non Hispanic White Beneficiaries | 2170 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 142 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1797 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 673 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5422 |